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Agency for Healthcare Research Quality


District of Columbia

Focus on Asthma

Asthma Care Quality Improvement: Could It Result in Positive Returns on Investment?

To see estimated savings (or increased costs) from a hypothetical asthma care quality improvement intervention program, choose a target audience you want to reach:

The estimates are generated by the AHRQ Asthma Calculator, a quality tool developed under AHRQ funding by Thomson Reuters. The calculator uses a meta-analysis of 52 research studies on improving asthma care to predict what those studies imply for the savings (or costs) of a hypothetical asthma care quality improvement program.

Asthma care improvement programs typically follow the guidelines of the National Asthma Education and Prevention Program (NAEPP). The NAEPP calls for education of patients and providers to better manage the disease. The NAEPP activities for patients focus on self-management to avoid triggers, anticipate problems, and use medications appropriately. The activities for providers focus on accurate diagnosis, appropriate medication prescribing, patient monitoring, and patient education on how to maintain control and avoid attacks. Often education leads to reductions in the need for hospitalization, emergency department visits, urgent office visits, and missed work or school days due to asthma attacks. Ultimately, these reductions save health care dollars and improve productivity.

The calculator uses the following information to estimate the return on investment for a user-defined asthma care quality improvement program:

Population characteristics:

  • Children, adults, or both
  • All asthma patients, only those with persistent asthma, or only those with persistent asthma and an acute visit1
  • Medicaid, employer-sponsored insurance, or State employees

Program characteristics:

  • Length of the program
  • Vendor cost of the program
  • Population and asthma prevalence (data for the 50 States and the District of Columbia are included)
  • Baseline (before the program) utilization and costs (default data are included)

User preferences:

  • Whether savings of direct medical costs and/or productivity gains will be calculated
  • Rigor of the research design to use in estimating savings
  • Benefits and costs from a third-party payer or society perspective


Based on the above inputs, the calculator provides information on how asthma-related costs are likely to change:

  • Total medical care savings (or costs)
    • Emergency department visits
    • Hospital stays
    • Outpatient visits
    • Medications
    • Ancillary testing
  • Productivity gains regarding missed school or workdays
  • Total savings (or costs)
    • Return on investment
    • Net present value
    • Breakeven point for program costs

For more information, see Methods.

1 Patients with an emergency department visit or an inpatient admission for which asthma was the principal diagnosis.